FOR THOSE whose surgical practices include the diagnosis and treatment of the acute surgical abdomen, the consideration of acute pancreatitis should preempt a position of high priority. Like "spontaneous" perforation of the esophagus, it is a disease process which is recognized advantageously only when it is thought of in the differential diagnosis of abdominal emergencies.
The incidence of traumatic, as well as nontraumatic, emergent surgical procedures at the Evanston Hospital is relatively high because of the hospital's community location. There has developed an awareness on the part of the staff of the manifestations of acute pancreatic inflammation, with a consequent modest, though definite, increase in the frequency of detection. Blatchford and Christopher1 reported the known Evanston experience in the 10 years between 1938 and 1947, inclusive. It is summarized in Figure 1 and characterized by (a) a significant mortality and (b) a high incidence of acute pancreatitis associated with